Otimização de Configuração de Estruturas Reticuladas

A presente dissertação tem como principal objetivo explorar a capacidade do programa PROAES calcular as derivadas das funções objetivo e constrangimento em relação a variáveis de configuração para resolver exemplos que combinam simultaneamente otimização de con- figuração e otimização topológica ou robusta de estruturas reticuladas. A otimização de configuração de estruturas reticuladas constituídas por barras está as- sociada à seleção mais adequada da orientação do eixo de cada um dos elementos na estru- tura e, num modelo de elementos finitos, as variáveis de configuração permitem modificar a orientação no espaço dos referenciais locais dos respetivos elementos estruturais. Este tipo de solução para otimizar o desempenho das estruturas, torna-se particularmente interessante quando combinada com otimização topológica, que permite que seja adicionado ou removido material dentro de um domínio de projeto, o que significa que quando ambas as otimizações se combinam surgem resultados bastante interessantes. A combinação foi também efetuada conjuntamente com otimização baseada em incerteza, de forma a enriquecer o estudo. De forma a testar a aplicabilidade destes conceitos de otimização simultaneamente, bem como averiguar as potencialidades das metodologias criadas, foram realizados diferentes tes- tes em estruturas compostas por elementos barra 2D e 3D recorrendo a casos de estudo refe- renciados na bibliografia, tendo sido criado um caso de estudo de raiz. Os resultados obtidos revelam um bom desempenho do programa e validam as metodologias utilizadas.The main objective of this dissertation is to explore the capabilities of the PROAES Pro- gram to calculate the gradients of objective and constraint functions with regard to configura- tion design variables to solve problems that involve simultaneously, Shape Optimization, To- pology Optimization and Robust Optimization. Shape Optimization of Truss Structures is associated with the most accurate selection of the axis of every single one of the elements that are part of the Truss Structure. That is con- nected with shape variables, which happen every time that the space orientation of local refe- rentials of the finite elements are modified. This type of solution, which has the objective of improving structural performance, is particularly interesting when combined with Topology Optimization. This later method allows material to be added or removed from the initial struc- ture within the project boundaries, which means that when the two types of Optimization are combined the potential results of the final structure are very interesting. It was also tested the possibility of combination with methods that regard uncertainty considerations in order to have a richer content in this study. In order to test the applicability of these concepts simultaneously as well as to test the potential results of the created methodologies some tests in 2D and 3D Truss Structures were developed from previous studies obtained in the literature and another case study was fully created. The results obtained show a good performance of the program and validate the used and developed methodologies

Evaluation of durability and resistance of steel anchorages in masonry walls

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Importation and early local transmission of COVID-19 in Brazil, 2020

We conducted the genome sequencing and analysis of the first confirmed COVID-19 infections in Brazil. Rapid sequencing coupled with phylogenetic analyses in the context of travel history corroborate multiple independent importations from Italy and local spread during the initial stage of COVID-19 transmission in Brazil

Mudanças na vida quotidiana em pessoas idosas institucionalizadas pelo impacto da doença

Objective: To verify the changes in daily life in institutionalized older adults caused by the impact of the disease, was the general objective of this ethnographic research. Method: The study was carried out with 99 residents of a long-term care institution for the elderly in southern Brazil. There was documentary research of the Institution and the permanence of the researcher to familiarize him with the environment and the entire public. Participant observation and semi-structured interviews were used for data collection. After the fieldwork, the data were analyzed through the description of the observation and the hermeneutic-dialectic method. Results: The results showed functional dependence, loss of autonomy, and personal control. Based on the participants’ comments, the study detected a lack of freedom, physical dependence to carry out routine activities, occupation reduction, isolation, and difficulty to sleep. The impairment of mobility was noted in the participant observation and the interviews. Conclusion: In the final remarks, the issue of qualitative research highlights the restriction of autonomy that older people are residing in the Institution in the face of the new conditions experienced in institutional life caused by the disease, which interferes with the quality of life of these residents.Objetivo: Verificar as mudanças na vida cotidiana em pessoas idosas institucionalizadas provocadas pelo impacto da doença foi o objetivo geral desta pesquisa etnográfica. Método: A pesquisa decorreu com 99 residentes de uma instituição de longa permanência para idosos, no sul do Brasil. Houve uma pesquisa documental da Instituição e a permanência do pesquisador para a familiarização deste com o ambiente e todo o público. A observação participante e a entrevista semiestruturada foram utilizadas para a coleta de dados. Após o trabalho de campo, os dados foram analisados por meio da descrição da observação e pelo método hermenêutico-dialético. Resultados: observou-se a dependência funcional, perda da autonomia e do controle pessoal. Nas falas dos participantes, constatou-se a perda da liberdade, a dependência física nas atividades do cotidiano, a diminuição da ocupação, o isolamento e a dificuldade para dormir. O acometimento da mobilidade foi notado na observação participante e nas entrevistas. Conclusão: Nas considerações finais a temática da pesquisa qualitativa destaca a restrição da autonomia que as pessoas idosas residentes da Instituição enfrentam diante às novas condições vivenciadas no quotidiano institucional ocasionado pela doença, o que interfere na qualidade de vida destes residentes

Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil

Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Manaus, Brazil, resurged in late 2020 despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1 acquired 17 mutations, including a trio in the spike protein (K417T, E484K, and N501Y) associated with increased binding to the human ACE2 (angiotensin-converting enzyme 2) receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7- to 2.4-fold more transmissible and that previous (non-P.1) infection provides 54 to 79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men